Pilot Experience Research Articles

Protocolizing social prescribing in mental health and addiction services: barriers and opportunities

Abstract Issue Social Prescribing (SP) is a structured approach where health professionals recommend community activities to enhance well-being. Starting in Catalonia in 2012, it expanded to the entire primary care network by 2016. By 2023, 23,338 patients received SP, showing a 2.3-fold increase from 2022. Two-thirds experienced improvement in mental well-being. Now, efforts focus on applying SP to mental health and addiction services (MHAS), where SP can be used for restoring health and well-being. Description A literature review was conducted and a working group was initiated with MHAS professionals was initiated to exchange experiences and identify needs and best practices. This was done in preparation for designing a pilot experience, which will include a qualitative study through focus groups to validate the action plan and determine barriers and facilitators in MHAS. The groups will be segmented into MHAS users and frontline professionals. Results The results of the review process and the working group sessions demonstrated that SP can be useful and beneficial for the health MHAS users. However, barriers and opportunities were identified. The main barriers detected include: the need for strong support during referrals to community activities; increased awareness of addiction among activity providers to reduce stigmatization; define inclusion and exclusion criteria; determining monitoring and evaluation tools; and mapping and updating community assets. Regarding opportunities, the following were highligthed: the interest of MHAS professionals in promoting and implementing a SP program in this area; the existence of organizations already conducting community activities focused MHAS users; and political prioritization of this issue. Lessons The implementation of a SP program protocol in MHAS is considered beneficial. It is necessary to analyse barriers to effectively address them and to identify opportunities to leverage them. Key messages • Social Prescribing has significantly enhanced mental health outcomes in Primary Care, which can imply a potential improvement in well-being of mental health and addiction services users. • Implementing Social Prescribing in mental health and addiction services offers promising integrated care opportunities, requiring barriers resolution and maximizing existing prospects.

Active offer of influenza vaccination during hospitalization: a multicenter study in Sicily (Italy)

Abstract Background Every cold season, the Italian health institutions strongly recommend influenza vaccination for categories at risk of complications, however influenza vaccination coverage is over and over far from the desirable target of 95%. After the pilot experience conducted in Palermo during the 2022-23 influenza season, the ‘Vaccinations in the ward’ project was extended to other Sicilian centers in order to evaluate the impact of the vaccination offer strategy in a broader territorial reality and to analyze the determinants of influenza vaccine acceptance among at risk people. Methods The project was conducted at the Umberto I Hospital in Enna and the University Hospitals of Messina and Palermo during the 2023-24 influenza season. A questionnaire was administered to the at risk hospitalized patients to investigate socio-demographic factors, behavioral habits, and clinical condition. Furthermore, influenza vaccination upon discharge was offered. Multivariable logistic regression was performed to identify the determinants of influenza vaccine acceptance. Results Overall, 374 patients with a median age of 65 years (IQR: 50-70) were recruited, of whom 36% had been vaccinated for influenza during the 2022-23 season (n = 136). The patients who accepted influenza vaccination in the ward were 57% (n = 214). The determinants of vaccination adherence were: age (OR: 1.03; p = 0.003); having quit smoking (OR: 2.68; p = 0.017); having received advice on vaccination from general practitioner (OR: 4.9; p < 0.001) and hospital healthcare workers (OR: 7.3; p < 0.001). Conclusions The offer of vaccination in the ward effectively increased influenza coverage among categories at risk of complications. Furthermore, the adoption of correct behavioral habits and the promotion of influenza vaccination by healthcare personnel have played a decisive role in the vaccine acceptance process. These findings could be useful for planning future influenza vaccination campaigns targeted to at risk people. Key messages • Vaccination strategies are needed to increase influenza coverage among at-risk categories. Active offer of influenza vaccine upon discharge can effectively increase vaccination compliance. • The adoption of correct behavioral habits and the promotion of vaccination by healthcare personnel play a decisive role in the influenza vaccine acceptance process among at risk people.

The co-design of building deep retrofitting in distressed urban areas: lessons from e-SAFE

ABSTRACT This article addresses the realm of co-design in building deep retrofitting in distressed urban areas. Drawing from a pilot experience conducted between 2020 and 2023 in Catania, Italy, as part of the Horizon 2020 project e-SAFE, the authors discuss the scholarly relevance of the lessons learned through a process of engagement of public housing residents in the co-design of their building’s retrofitting. Drawing from both socio-technical and urban planning literature, the paper conceptualises co-design as a process that should provide spaces for shared learning and creativity, on the one side, and negotiability between residents and experts, on the other. In the Catania experience, co-design has encountered several obstacles, especially due to strings attached to the funded grant as well as the unfortunate socio-political conjuncture. While these obstacles made it hard to keep spaces of shared creativity open, it was crucial to at least provide spaces for negotiation, especially over those technological choices having a direct impact on residents’ relational economics. In general, the paper argues the importance of distinguishing between these two dimensions ensuring flexibility, so that even if shared creativity is constrained by circumstances, negotiable spaces can still be provided.

Innovative Methodologies in University Teaching: Pilot Experience of an Escape Room in Nursing Students

The presence of playful elements in learning environments is increasingly frequent in university settings. The objective of this study was to evaluate the gaming experience of the participants of an escape room activity developed in the second year of the Bachelor of Science in Nursing program. An escape room activity was carried out, based on 10 tasks, on the thematic content of the subject ‘History, Theory and Methods of Nursing II’, with students in the second year. After the game experience, the Gameful Experience Scale (GAMEX) questionnaire of 27 items in the validated version in Spanish and for nursing students was applied. An open-ended question was also included to allow the students to give their opinion on aspects of improvement, or their feelings during their performance, and a thematic analysis was utilized for this qualitative approach. A total of 107 students participated in the escape room activity, and 75 individuals acceded to the request to be surveyed. The results in the Enjoyment dimension showed that five of the six questions were assessed with the maximum score by the majority of respondents. In the Absorption dimension, between 15% and 25% of the sample did not manage to abstract themselves from the real world. In the dimensions of Creative Thinking and Activation, up to 70% managed to feel imaginative, creative, or exploratory, feeling active and excited. Nearly 85% of the sample reported the Absence of Negative Affect (hostility, annoyance, or frustration) during the game. In the Dominance dimension, up to 70% of the sample considered feeling influential during the game. Two categories were identified after analyzing the participants’ responses: room for improvement in the activity and feelings during the activity. In conclusion, the escape room is positioned as a useful tool for university teaching in nursing. This didactic game allows students to have fun while learning, and to value the knowledge and techniques provided by the subject while being able to work as a team.

Vaccinations at home: a new strategy to contain vaccine hesitancy? The experience of ASL Napoli 1 Centro, Italy.

Vaccination coverage are generally geographically variable, even within large cities; furthermore, across target population are embedded difficult-to-reach clusters. To address this issue and improve coverage of mandatory vaccinations, a study group explored bringing vaccination at home as an interventional strategy. In a pilot experience, parents of unvaccinated and under vaccinated children of the 2020 birth cohort living in Naples, Italy were contacted by telephone to offer home administration of vaccinations. A specifically trained team arranged vaccinations visits at home. Coverage rates were evaluated at baseline and one month after the intervention strategy. A significant positive increase in hexavalent vaccine (+1.43%) and measles-mumps-rubella (+1.85%) coverage was registered despite the short duration of the pilot program. Home vaccination turned out to be a medical resource consuming but feasible and successful strategy to increase mandatory vaccinations coverage among the most difficult-to-reach and fragile segments of the pediatric population.

Prostate Cancer Stratified Self-Managed Follow Up (SSMFU): Our Pilot Experience

Prostate Cancer Stratified Self-Managed Follow Up (SSMFU): Our Pilot Experience

Feasibility and Accuracy of Ultrasound-Guided Core Needle Biopsy for Nipple Lesions: A Pilot Study.

Due to the superficial location, suspicious findings of the nipple-areolar complex (NAC) are not amenable to stereotactic or MRI-guided sampling and have historically necessitated surgical biopsy or skin-punch biopsy. There are limited reports of US-guided core biopsy of the nipple (US-CBN). We report our nearly 3-year pilot experience with US-CBN at an academic breast imaging center. An institutional review board-exempt and HIPAA-compliant retrospective review was performed. We assessed patient demographics, breast imaging characteristics, procedural data, pathology, and outcomes. Nine female patients aged 27 to 64 underwent US-CBN from January 2021 to October 2023. Initial imaging abnormalities included abnormal MRI enhancement, mammographic calcifications, and sonographic masses. After initial or second-look US, all imaging findings had sonographic correlates for biopsy specimens, the majority of which were sonographic masses (8/9). US-CBN was performed by 6 breast radiologists using a variety of devices. All biopsy specimen results were concordant with sonographic abnormalities, although 1 was considered discordant from the initial abnormality seen on MRI. There were no complications, and discomfort during the procedure was well-treated. Two patients (22%, 2/9) were diagnosed with malignancy. This pilot study demonstrated that US-CBN can be performed by a breast radiologist for definitive diagnosis of suspicious nipple abnormalities seen on breast imaging, avoiding surgery, and maintaining nipple integrity. In our population, 22% (2/9) of US-CBNs revealed malignancy.

Erratum: Patient-Reported Outcomes Improve Following Mastectomy for Early-Stage Breast Cancer in Nigeria: Pilot Experience Using a Translated and Validated BREAST-Q.

Erratum: Patient-Reported Outcomes Improve Following Mastectomy for Early-Stage Breast Cancer in Nigeria: Pilot Experience Using a Translated and Validated BREAST-Q.

Information society in regions: pilot experiences

Nos últimos tempos as tecnologias de informação e de comunicação têm sido alvo de um profundo e rápido desenvolvimento ql:Je se materializou numa verdadeira revolução ao nível de infra-estruturas, serviços e aplicações. Esta transformação aparece difundida por todas as sociedades, assenta sobre o hiper sector da informação e afecta todos os estados, regiões e cidadãos. A Comissão Europeia, consciente desta realidade tem vindo a empenhar-se no desenvolvimento da Sociedade da Informação, patente nos diversos documentos elaborados e no lançamento de iniciativas-piloto. Com este trabalho pretende­se analisar alguns dos projectos-piloto e alcançar lições de experiências.

Patient-Reported Outcomes Improve Following Mastectomy for Early-Stage Breast Cancer in Nigeria: Pilot Experience Using a Translated and Validated BREAST-Q

PURPOSE Mastectomy without reconstruction is recommended for most Nigerian women with non-metastatic breast cancer (BC), but only 43% receive surgery, partly due to psychosocial factors. Patient-reported outcome measures (PROMs) are valuable tools for improving patient-centered care. BREAST-Q is a validated PROM for evaluating satisfaction and health-related quality of life after BC surgery. This research aimed to measure the effect of mastectomy on PROMs across BC stages in Nigeria, using BREAST-Q for the first time in this setting. METHODS A psychometrically validated, Yoruba version of the BREAST-Q mastectomy module was administered pre-operatively and at multiple time-points post-operatively to Nigerian women with non-metastatic BC undergoing mastectomy at three academic institutions. Domains: psychosocial well-being, physical well-being chest, sexual well-being and satisfaction with breasts, had both pre-and post-operative applicability. BREAST-Q scores were transformed into RASCH equivalents (0=worst, 100=best). Differences between scores pre-operatively and at 6-months post-operatively were compared using a paired t-test within early-stage (I/II) and late-stage (III) cohorts. RESULTS 108 patients had a median age of 50 (IQR 43, 59). 102 had documented stage: I–5 (5%), II–42 (41%), and III–55 (54%). 90 (83%) received neoadjuvant chemotherapy. 12 (11%) received post-mastectomy radiation. Mean pre-operative BREAST-Q scores across all domains were lower for early- vs. late-stage disease. Patients with early-stage BC had significantly higher mean BREAST-Q scores at 6-months post-operatively than pre-operatively in three of four domains: psychosocial well-being (pre-op: 60/post-op: 67, p-value=0.024), physical well-being chest (pre-op: 13/post-op: 27, p-value<0.001), and satisfaction with breasts (pre-op: 55/post-op: 65, p-value=0.031). Sexual well-being was not significantly different between time-points (pre-op: 29/post-op: 24, p-value=0.3). In patients with late-stage BC, psychosocial well-being (pre-op: 66/post-op: 67, p-value=0.6), physical well-being chest (pre-op: 22/post-op: 20, p-value=0.5), and satisfaction with breasts (pre-op: 58/post-op: 52, p-value=0.13) scores were similar pre- and 6-months post-operatively. Sexual well-being decreased significantly at 6-months (pre-op: 42/post-op: 25, p-value<0.001). CONCLUSION We report the first-ever use of the BREAST-Q in Nigeria. PROMs following mastectomy were unchanged or better in most domains. Significant improvement was seen in patients with early-stage disease. These results can inform pre-operative patient counseling to guide expectations and reduce fear. Interventions to improve sexual well-being are needed for patients with late-stage disease.

Human Factors in General Aviation Loss of Control: Survey of Pilot Experiences

Inflight loss of control (LOC-I) is a major cause of general aviation (GA) accidents. Previous studies have identified LOC-I causes from sources such as the National Transportation Safety Board (NTSB) database. NTSB GA accident reports include limited detail on human factors. Getting pilots’ perspectives from other sources, such as surveys, may reveal insights into pilot actions and conditions. This study investigates the role of human factors in LOC-I by analyzing demographics in NTSB accidents and conducting a survey of pilots’ LOC-I experiences based on the Human Factors Analysis and Classification System framework. Note that 80% of the LOC-I events shared by the pilots involved pilot error, most of which were skill-based and decision errors. About one-quarter of pilots mentioned that their instructor had not prepared them well or taught them methods to recover from LOC-I. Several pilots mentioned that, because of their lack of LOC-I recovery training, they could not recover from LOC-I. The study helped in identifying specific pilot errors and issues in training that were not mentioned explicitly in the NTSB reports. Findings from the study may help improve training methods and operating procedures for GA pilots to prevent loss of control in the future.

Promoting abstract thinking and scientific argumentation in the teaching of physics

thinking and scientific argumentation are two of the more important high-order cognitive skills that students at secondary level need to develop in the learning of physics. In this paper a new methodology based on constructivism’s view of education is presented by using counterintuitive experiments under a POE strategy (Predict, Explain, Observe). The experiments consist in a race of two soda can, one of them previously shaken, over an inclined plane; and the movement of a double cone object, built by two joined funnels, over two convergent inclined rails. The unexpected outcome of both experiments challenges the prior ideas of the students and provokes a higher engagement in their learning process. The results of a pilot experience applying this methodology suggest that using counterintuitive experiments under PEO strategy is an effective methodology to introduce the teaching of abstract concepts as moment of inertia and centre of mass. It also helps identifying students’ prior knowledge, promoting the use of scientific reasoning, and training students in the activation of their abstraction skills.

Survival After Ditching in Motorized Aircraft, 1989-2022.

INTRODUCTION: Although an unintended aircraft landing on water (referred to as ditching) is a rare event, the potential for occupant injury/fatality increases immediately following the event due to adverse conditions. However, to date, few studies have addressed the subject. Herein, ditching events and post-ditching survival were investigated.METHODS: Ditchings (1982-2022) in the United States were identified from the National Transportation Safety Board database. Occupant injury severity, aircraft type, pilot experience, flight conditions, and number of occupants were extracted. Poisson distribution, the Chi-squared test (2-tailed), Mann-Whitney U test, and Kruskal-Wallis one-way analysis of variance were employed.RESULTS: A total of 96 ditchings were identified. A systematic survey was hampered by the lack of a standardized reporting matrix in the reports. In total, 77 reports were included in the analysis. Across all ditchings, 128 of 169 (76%) occupants survived ditching and were rescued. Importantly, the initial ditching event was survived by 95% of all occupants. However, 32 (19%) occupants died post-ditching by drowning (21/32 cases) or for undetermined reasons. Considering probability per ditching event, in 26 (34%) of all ditchings, one or more occupants was/were fatally injured.DISCUSSION: Initial survival of the emergency ditching is high. Drowning was the leading cause of death after ditching and reduced the overall survival to 76%. Further investigation is needed to identify risk factors for fatal outcomes and/or improve probability of survival after ditching.Schick VC, Boyd DD, Hippler C, Hinkelbein J. Survival after ditching in motorized aircraft, 1989-2022. Aerosp Med Hum Perform. 2024; 95(5):254-258.

Canicross Pilot Programme: Basic Considerations for Its Implementation as an Extracurricular Sports Activity

Canicross is a sport that consists of running while being pulled by a dog in a natural environment. Due to the benefits to health and well-being that it brings to the people and dogs that practise it, this sport could be implemented as an animal-assisted intervention (AAI) in the educational field. Against this background, the present work describes a pilot experience carried out in an educational centre in the Basque Country for the implementation of canicross as an extracurricular sports activity. The main objective is to describe the educational potential of canicross as an extracurricular activity that fosters students’ values of respect for animals and physical activity (PA) in natural environments. The results of this innovative experience provide the first evidence of the valuable role of animal activities in this educational context, where current academic research is practically non-existent. In conclusion, we highlight the novelty of the proposal and the motivating effect that the dogs in this case had among the students in encouraging them to practise PA and adhere to values of respect and animal welfare.

Cultivating Value: Teaching a Job and Mitigating Climate Change Effects While Restoring a Landscape Heritage

Abstract In the degraded peri-urban areas, there are several traces of the agrarian landscape heritage: they are not relicts of the past but a resource for managing water, providing fauna and flora biodiversity, and mitigate climate change in the urban environment. A pilot experience of recovering the Milan medieval water meadows has been done in the last two years: the aim was to provide a new job to fragile people, while restoring an ancient landscape. The tangible permanencies have been recovered by unemployed people at the same time as the traditional art of managing water has been taught by ancient watermen. A course has been organized to transfer the knowledge. Several schools have been involved in the practical recovery of artifacts: students enjoyed to care an “ordinary” heritage in their neighbourhood, as a resource for a sustainable way of living, and a good quality landscape. The high social and cultural value provided increased Municipality’s attention to consider a joint management with the social cooperative of this productive landscape and to include didactical visit to water meadow in each student curricula.

Моделирование деятельности экипажей при пилотировании воздушных судов

<p>The paper considers the representation of crew activities when piloting an aircraft using Markov chains, including modeling in regular and emergency situations, considering the experience of the crew. A method for assessing the level of pilot experience using a neural network and an algorithm for optimizing the probability matrices of transitions between model states are presented. Examples of modeling for an emergency situation are given, demonstrating the influence of the pilot's level of experience on the result.</p>

Culinary Medicine Experiences for Medical Students and Residents in the U.S. and Canada: A Scoping Review

Phenomenon Despite the importance of diet in the prevention and management of many common chronic diseases, nutrition training in medicine is largely inadequate in medical school and residency. The emerging field of culinary medicine offers an experiential nutrition learning approach with the potential to address the need for improved nutrition training of physicians. Exploring this innovative nutrition training strategy, this scoping review describes the nature of culinary medicine experiences for medical students and resident physicians, their impact on the medical trainees, and barriers and facilitators to their implementation. Approach This scoping review used the Joanna Briggs Institute methodology for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews (PRISMA-ScR) checklist as guides. Eligible publications described the nature, impact, facilitators, and/or barriers of nutrition and food preparation learning experiences for medical students and/or residents. Additional inclusion criteria were location (U.S. or Canada), allopathic or osteopathic, English, human subjects, and publication year (2002 or later). The search strategy included 4 electronic databases. Two reviewers independently screened titles/abstracts and a third reviewer resolved discrepancies. The full-text review consisted of 2 independent reviews with discrepancies resolved by a third reviewer or by consensus if needed, and the research team extracted data from the included articles based on the nature, impact, barriers, and facilitators of culinary medicine experiences for medical trainees. Findings The publication search resulted in 100 publications describing 116 experiences from 70 institutions. Thirty-seven publications described pilot experiences. Elective/extracurricular and medical student experiences were more common than required and resident experiences, respectively. Experiences varied in logistics, instruction, and curricula. Common themes of tailored culinary medicine experiences included community engagement/service-based learning, interprofessional education, attention to social determinants of health, trainee well-being, and cultural considerations. Program evaluations commonly reported the outcome of experiences on participant attitudes, knowledge, skills, confidence, and behaviors. Frequent barriers to implementation included time, faculty, cost/funding, kitchen space, and institutional support while common facilitators of experiences included funding/donations, collaboratives and partnerships, teaching kitchen access, faculty and institutional support, and trainee advocacy. Insights Culinary medicine is an innovative approach to address the need and increased demand for improved nutrition training in medicine. The findings from this review can guide medical education stakeholders interested in developing or modifying culinary medicine experiences. Despite barriers to implementation, culinary medicine experiences can be offered in a variety of ways during undergraduate and graduate medical education and can be creatively designed to fulfill some accreditation standards.

Visualizing Academic Contributions to Achieving the Sustainable Development Goals through AI: The Case of Universitat Politècnica de València.

How are you contributing to SDGs and measuring sustainable improvements? AI solutions can help you to quantify it. This pilot experience shows the case of the university's scientific contributions.

(1066) - Pilot Experience with Heart After Liver Transplantation with Domino (HALT-D) for Highly Allosensitized Recipients: Midterm Outcomes

(1066) - Pilot Experience with Heart After Liver Transplantation with Domino (HALT-D) for Highly Allosensitized Recipients: Midterm Outcomes

WCN24-545 Incremental start and modulation of hemodialysis frequency may be based on clinical assessment and biochemical data without need for 24 hour urine collection. A pilot experience

WCN24-545 Incremental start and modulation of hemodialysis frequency may be based on clinical assessment and biochemical data without need for 24 hour urine collection. A pilot experience